Move all non-emergency NHS work into primary care, say health groups

All non-emergency NHS treatment should be moved out of hospitals and into primary care, according to a report by leading health organisations.

Dr Michael Dixon: primary care not just about general practice (Photo: Steffan Hill)
Dr Michael Dixon: primary care not just about general practice (Photo: Steffan Hill)

The We Are Primary Care report, jointly developed by Pharmacy Voice, NHS Alliance, the Optical Confederation and the National Community Hearing Association, warned that the future of the NHS was ‘precarious’ if the current medical model was maintained.

The report calls for increased investment into community primary care services such as pharmacy and optometry - boosting these services could ease GP workloads and improve patient care, it says.

The report calls for all non-emergency treatment, including care for long-term conditions and minor ailments, to be taken out of hospitals and into primary care.

But the report said the public’s lack of understanding about primary care, coupled with a ‘dramatic imbalance in funding’ between primary and secondary care, was acting as a ‘significant barrier’ to this move.

Members of the public generally have little understanding of what is meant by ‘primary care’ and are ‘confused’ about who can provide it, the report says.

Patients unaware of primary care services

A better understanding of primary care would help the public ‘navigate the NHS more effectively and appropriately’ in addition to ‘relieving pressure points in general practice and A&E’.

According to a survey commissioned for the report, although 74% of people recognise GPs as primary care providers, nearly half (47%) falsely regard A&E as a part of primary care.

Only between 25% and 35% realised that community pharmacists, optometrists or community hearing aid services are part of primary care, even though they account for more than 40% of the primary care budget.

The report calls for a greater emphasis on these ‘high street’ primary care services, which it says are well placed to help patients combat risk factors such as smoking and obesity.

Dr Michael Dixon, chairman, NHS Alliance said: 'Primary care isn’t, and shouldn’t be, all about general practice. Rather, primary care should be seen as a cohesive whole bringing together community pharmacy, community eye care and hearing services, dental practice and even providers of housing, emergency services and communities themselves alongside general practice.'

Professor Robert Darracott, chief executive of Pharmacy Voice, said patients should think of general practice as ‘a gateway to managing ill health’, and the other primary care services as a ‘gateway to proactive good health’.

There are over 100,000 primary care professionals working in pharmacy, dentistry, optometry and audiology, the majority of whom work in high street locations with extended opening hours, who are currently a missed opportunity to shoulder some of the GP workload, the report authors said.

'Radical' thinking needed for NHS to survive

Professor Darracott added: ‘We have to be radical in our thinking and our actions if the NHS is to survive in its current form.

‘1.6m people visit their community pharmacy every day, creating a real opportunity for us to dispense health as well as medicines, helping people stay well, and potentially resulting in billions saved in hospital admissions further down the line.’

The report also encouraged patients to seek primary care as a preventative measure, instead of burdening hospitals with ‘unsustainable’ demand and at greater cost to the NHS later down the line.

It cited how lifestyle risk factors such as smoking, excess alcohol and poor diet, which can be dealt with in primary care, are linked to an estimated 80% of deaths from major diseases, including cancer and heart disease.

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